Thiazides

Thiazides and Skin Cancer? Don’t Get Burned By the Hype

Thiazide-type diuretics reduce the risk for mortality, stroke, and cardiovascular disease among patients with hypertension.1 Given the reasonable adverse effect profile and high-quality evidence for efficacy, thiazide-type diuretics are one of the most commonly prescribed antihypertensive agents worldwide.

Thiazides in the management of hypertension in older adults – a systematic review

The use of low dose treatment with thiazides for the management of hypertension in adults aged 65 and older seems justified, unless a history of gout is present. The quality of the evidence is low and studies rarely describe characteristics of the participants such as polypharmacy and frailty. Further good quality studies are needed.

Is there a place for thiazide diuretics in the management of hypertension?

Apart from the now uncommon situation of excessive drug-induced salt and water retention, thiazides are more effective and better tolerated as antihypertensives than the more potent loop diuretics.

Hydrochlorothiazide

The usual initial dose in adults is 25 mg daily given as a single dose. The dose may be increased to 50 mg daily, given as a single or two divided doses.

OzEMedicine

Site of action is at early distal tubule where they block electroneutral Na-Cl co-transport resulting in a modest increase in Na excretion (NB. 90% Na already reabsorbed!).

Cochrane

Different thiazide drugs have similar effects in lowering blood pressure and thiazides lower systolic blood pressure more than other classes of antihypertensive drugs.

StatPearls

Thiazide diuretics are an FDA-approved class of drugs that inhibit the reabsorption of 3% to 5% of luminal sodium in the distal convoluted tubule of the nephron. By doing so, thiazide diuretics promote natriuresis and diuresis. Three thiazide diuretics are the most commonly used: hydrochlorothiazide (HCTZ), chlorthalidone, and indapamide.